Ensuring medication safety: a shocking incident that exposed a dangerous flaw
At six-week intervals, I replenish my supply of omeprazole. Initially, I took it for symptomatic relief of GERD, becoming symptomatic again within a week or two during periodic self-directed suspensions. An esophagogastroduodenoscopy, done for another reason, disclosed Barrett’s esophagus, shifting that daily pill of personal comfort to a more essential intervention. It falls within several
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Ensuring medication safety: a shocking incident that exposed a dangerous flaw originally appeared in KevinMD.com. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - June 28, 2023 Category: General Medicine Authors: Richard Plotzker, MD Tags: Meds Gastroenterology Medications Source Type: blogs
Gastroenterology Embraces Artificial Intelligence
AI and machine learning have the potential to redefine the management of several GI disorders.John Halamka, M.D., president, Mayo Clinic Platform, and Paul Cerrato, senior research analyst and communications specialist, Mayo Clinic Platform, wrote this article.Colonoscopy is one of the true success stories in modern medicine.Studies have demonstrated that colonoscopy screening detects the cancer at a much earlier stage, reducing the risk of invasive tumors and metastatic disease, andreducing mortality. However, while colorectal cancer is highly preventable, it is thethird leading cause of cancer-related deathsin the U.S. A...
Source: Life as a Healthcare CIO - October 13, 2021 Category: Information Technology Source Type: blogs
A Man With Sudden Onset of Gastroparesis
By HANS DUVEFELT
Leo Dufour is not a diabetic. He is in his mid 50s, a light smoker with hypertension and a known hiatal hernia. He has had occasional heartburn and has taken famotidine for a few years along with his blood pressure and cholesterol pills.
Over the past few months, he started to experience a lot more heartburn, belching and bloating. Adding pantoprazole did nothing for him. I referred him to a local surgeon who did an upper endoscopy. This did not reveal much, except some retained food in his stomach. A gastric emptying study showed severe gastroparesis.
The surgeon offered him a trial of metoclopra...
Source: The Health Care Blog - September 16, 2021 Category: Consumer Health News Authors: Christina Liu Tags: Medical Practice Physicians Primary Care Hans Duvefelt Source Type: blogs
Is IBD an underrecognized health problem in minority groups?
As many people know, inflammatory bowel disease (IBD) is a complex condition affecting the intestine, which is the part of the digestive tract that helps digest food and remove water, salt, and waste.
But you might not know this: in recent years in the US, IBD is being diagnosed more often among people who are Black, Hispanic/Latinx, East and Southeast Asian, or from other minority groups than it was in past decades.
Is this a true rise in cases? Is IBD underrecognized in minority populations? While we don’t have all the answers yet, exploring health disparities in IBD and explaining its symptoms may encourage more peopl...
Source: Harvard Health Blog - May 7, 2021 Category: Consumer Health News Authors: Adjoa Anyane-Yeboa, MD, MPH Tags: Digestive Disorders Health Health care disparities Inflammation Source Type: blogs
Functional dyspepsia: Causes, treatments, and new directions
Functional dyspepsia (FD) is a common condition, loosely defined by some physicians as a stomach ache without a clear cause. More specifically, it is characterized by the feeling of fullness during or after a meal, or a burning sensation in the mid-upper abdomen, just below the rib cage (not necessarily associated with meals). The symptoms can be severe enough to interfere with finishing meals or participating in regular daily activities.
Those with FD often go through multiple tests like upper endoscopy, CT scan, and gastric emptying study. But despite often-severe symptoms, no clear cause (such as cancer, ulcer disease, ...
Source: Harvard Health Blog - July 6, 2020 Category: Consumer Health News Authors: Vikram Rangan, MD Tags: Digestive Disorders Mind body medicine Pain Management Source Type: blogs
Eosinophilic esophagitis: A new food-related allergic condition on the rise?
In the early 1990s, doctors began describing a new condition affecting the esophagus of patients who were predisposed to allergies including food allergy, asthma, and eczema, and who were having trouble swallowing. Today, we call this condition eosinophilic esophagitis (EoE).
What is EoE?
EoE is an allergic inflammation of the esophagus that causes a range of symptoms. Adolescents and adults most often experience it as difficulty swallowing, sometimes feeling like food moves too slowly through the esophagus and into the stomach. In some cases, food actually gets stuck (and may require urgent removal). Children and some adu...
Source: Harvard Health Blog - December 26, 2019 Category: Consumer Health News Authors: John Garber, MD Tags: Allergies Digestive Disorders Health Source Type: blogs
MKSAP: 30-year-old man with ongoing symptoms of dysphagia
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 30-year-old man is evaluated for ongoing symptoms of dysphagia. He was previously diagnosed with eosinophilic esophagitis on upper endoscopy and has completed an 8-week course of swallowed aerosolized fluticasone, which di d not alleviate his symptoms. He takes no other medications. […]Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - October 12, 2019 Category: General Medicine Authors: < span itemprop="author" > < a href="https://www.kevinmd.com/blog/post-author/mksap" rel="tag" > mksap < /a > < /span > Tags: Conditions Gastroenterology Source Type: blogs
MKSAP: 35-year-old man with persistent heartburn
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 35-year-old man is evaluated during a follow-up appointment for persistent heartburn with chronic cough. He has a 1-year history of gastroesophageal reflux disease and takes pantoprazole twice daily. He reports no nausea, vomiting, or dysphagia. Upper endoscopy performed 1 year […]Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - August 10, 2019 Category: General Medicine Authors: < span itemprop="author" > < a href="https://www.kevinmd.com/blog/post-author/mksap" rel="tag" > mksap < /a > < /span > Tags: Conditions Gastroenterology Source Type: blogs
Diagnosing Esophageal Cancer More Accurately: Interview with Mark Rutenberg, CEO of CDx Diagnostics
Cancer of the esophagus is often related to chronic heartburn, something patients too often end up ignoring. The onset of the potentially deadly disease can be detected, though, given good enough imaging and regular screenings. The imaging component, that we’re particularly interested in, relies on physicians to take biopsies of random bits of the esophageal tissue and to then examine it under the microscope. Since precancerous cells are spread out randomly, it is very easy to miss the development of cancer.
CDx Diagnostics has developed a technology that allows physicians to take more comprehensive samples and to ha...
Source: Medgadget - March 13, 2019 Category: Medical Devices Authors: Editors Tags: Exclusive GI Pathology Surgery Source Type: blogs
MKSAP: 60-year-old woman with H. pylori gastritis
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 60-year-old woman is evaluated 1 month after completing a 14-day course of Helicobacter pylori eradication therapy consisting of amoxicillin, clarithromycin, and omeprazole. Initial upper endoscopy before treatment showe d patchy gastric erythema with no ulcers or erosions, and biopsies revealed H. pylori gastritis. Currently, she […]Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - February 16, 2019 Category: General Medicine Authors: < span itemprop="author" > < a href="https://www.kevinmd.com/blog/post-author/mksap" rel="tag" > mksap < /a > < /span > Tags: Conditions Gastroenterology Source Type: blogs
MKSAP: 48-year-old man with a 4-week history of heartburn
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 48-year-old man is evaluated for a 4-week history of heartburn that awakens him at night. The symptoms occur about three times per week. He has been taking over-the-counter antacids with incomplete relief. Food triggers include coffee and spicy foods. He has not had unintentional weight loss or difficulty swallowing.
Physical examination and laboratory studies are normal.
Which of the following is the most appropriate next step in management?
A. Ambulatory esophageal pH monitoring
B. Esophageal manometry
C. Tr...
Source: Kevin, M.D. - Medical Weblog - September 11, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/mksap" rel="tag" > mksap < /a > Tags: Conditions Gastroenterology Source Type: blogs
Do you get brain fog with probiotics?
We may now have an explanation for the people who experience brain fog with probiotic use.
We already know that intolerance to prebiotic fibers within the first 60 minutes of ingestion have small intestinal bacterial overgrowth, SIBO. If you experience excessive gas, bloating, abdominal discomfort, or diarrhea within the first hour of consuming, say, inulin, a raw white potato, or legumes, it is virtually certain that you have SIBO that must be addressed if you desire full recovery of health. Recall that uncorrected SIBO can account for fibromyalgia, IBS, restless leg syndrome, psoriasis, and marked long-term potential for...
Source: Wheat Belly Blog - August 4, 2018 Category: Cardiology Authors: Dr. Davis Tags: News & Updates Source Type: blogs
MKSAP: 70-year-old man with heartburn
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 70-year-old man is evaluated in follow-up for heartburn of 7 years’ duration. He has frequent nocturnal reflux but has not had odynophagia or dysphagia, and his weight has been stable. He was recently started on once-daily omeprazole with good control of his symptoms. He has a 30-pack-year history of cigarette smoking and continues to smoke.
On physical examination, vital signs are normal; BMI is 29. The remainder of the physical examination is normal.
He is concerned about his long-term heartburn sympto...
Source: Kevin, M.D. - Medical Weblog - July 21, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/mksap" rel="tag" > mksap < /a > Tags: Conditions Gastroenterology Source Type: blogs
Case of the Week 499
Reminder - I am still taking parasite art submissions for Case of the Week 500! I will feature all artwork on my blog, along with the results of the drawing for 3 prizes :)Now for this week ' s case, we have a very interesting submission from Dr. David Peaper. The patient is an elderly woman presenting with hematemesis. She underwent upper endoscopy and biopsies were taken from areas of erosion/inflammation. The biopsies were submitted for comprehensive vial culture, and the following were observed in the MRC-5 shell vials and traditional tube cultures.Identification? (Source: Creepy Dreadful Wonderful Parasites)
Source: Creepy Dreadful Wonderful Parasites - June 25, 2018 Category: Parasitology Source Type: blogs
MKSAP: 78-year-old man with symptoms of dysphagia
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 78-year-old man is evaluated for symptoms of dysphagia that began 2 weeks ago. When he eats, he starts coughing after the first bite of food and occasionally has nasal regurgitation.
On physical examination, blood pressure is 135/90 mm Hg, pulse rate is 78/min, and respiration rate is 12/min. Left-sided weakness is noted in both extremities, upper greater than lower.
Which of the following is the most appropriate diagnostic test to evaluate this patient’s dysphagia?
A. Barium swallow
B. Esophageal manome...
Source: Kevin, M.D. - Medical Weblog - June 9, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/mksap" rel="tag" > mksap < /a > Tags: Conditions Gastroenterology Otolaryngology Source Type: blogs
